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General NPI Number Information
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NPI Number | 1356948947
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Entity Type | Organization
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Legal Business Name | HALO COMMUNITY SERVICES
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Dates
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Enumeration Date | 10/06/2020
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Last Update Date | 10/06/2020
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Provider Practice Location Address
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Address Line | 12133 W BELL RD
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City | SURPRISE
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State | AZ
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Zip | 85378-9409
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Country | US
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Telephone | 623-229-5825
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Fax |
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Provider Business Mailing Address
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Address Line | 15778 W CARIBBEAN LN
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City | SURPRISE
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State | AZ
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Zip | 85379-6238
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Country | US
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Telephone | 623-229-5825
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | THANIA PENNINGTON
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Credential | MA
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Telephone | 623-229-5825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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